Arpita: Hi, everybody. Welcome again to another episode of Doctors Living Deliberately. I am here today with my co-host Dr. Michael Hersh. How you doing, Michael? 

Michael: I'm good. How are you Arpita?

Arpita: I am good. I am chugging along with life, and I am so excited to also have our guest here today, Dr. Erica Howe. Dr. Erica is a board certified hospitalist, and she is a nationally known educator, wife and mother to three crazy kids. She is a prolific speaker and lifelong advocate for improving wellness in medicine. She's given over 200 talks, both nationally and internationally on topics like conflict management, gaining clarity in our clinical careers, time management and boundary setting. In 2018, she founded the Women Physician Wellness Conference as a way of bringing women physicians together to share their struggles and their strategies for success, and believes that women are stronger together. She inspires them to find the courage, clarity, and community to succeed on their own terms. I have had the honor of attending her conferences as well as being a speaker at her conferences, and it is a magical place, almost as magical as Disneyland maybe, maybe. So welcome, Erica, tell us a little bit about yourself. 

Erica: Hello everybody. Thank you so much, Michaeland Arpita. I appreciate the opportunity to be here with you and your audience. I am a hospitalist by training. I practiced for nearly 20 years, and gosh, back in about 2018, I was one of those typical burnout physicians and I got this little spark in my head about maybe finding a way to create a community of other women physicians where we could come together and kind of share some of our struggles as well as strategies for success. And that's kind of how W P W or the Women Physicians Wellness Conference was born. And it's just grown ever since. 

Arpita: I remember your story. You said something about walking out of the parking lot, maybe post call. Share that story with the listeners. Cause it really resonated with me. I was like, oh yeah, I've been there. 

Erica: Right. You know, I, and I think probably most of us have. I had had three kids in five years, fresh out of residency. So it's, you know, I had a year as faculty and then I started having babies and you know, growing our family. And as any young mother knows, or new mother knows, it's a lot to bite off new fathers too. It's just, it's a lot. It's more than you ever think it's gonna be. And I was struggling. I was just, I was burnt out. I felt like, I didn't know how to like do all these things and hold all these balls in the air all the time. I remember that I used to walk down this hallway that connected our offices right where the elevator left our offices left the elevator to go to the garage for our parking. And it was like a two minute walk. And as I would walk there, this was what I called my hallway of shame. I would basically reflect on all the ways in which I was failing at whatever job I'd just come from. If I had just come from dropping my kids off and I was walking into work, I was reflecting on how I sucked as a mom and how, you know, I should be spending more time with them and I dropped them off too early. And yes, I needed to get there to pre-round, but, you know, all the guilt and the shame associated with that. And then, when I was leaving work, I was feeling all this guilt for, you know, not spending more time with my patients, and I wish I could be here a couple more hours so I could really dedicate myself. And I really need to write that paper and you know, I need to work on that talk. And so either way I was going, whether I was coming to work or leaving work, I was feeling shame and guilt and just like I did not have it together. 

And yet I would look around and it looked like everybody else had it together. Right? And what is the media that we all grew up with show us? it, you know, I grew up watching Grey's Anatomy and ER, and all of these medical dramas where, you know, the doctor rushes in and like always saves the day and always has everything kind of calm and cool and collected. And I especially felt like that was how I needed to appear to other people, especially as a woman physician, because, you know, there weren't as many of us and we were, you know, rising up the ranks more slowly, et cetera, et cetera. So I felt like I always needed to look like I had it together. So if anybody would ask me, you know, how are you doing? I'd say, great, how are you? And I remember one night I was packing up my things to go get on that elevator to go down to my hallway of shame. And I had a colleague that walked by and he said, you know, Hey Erica, how's it going? And I said, oh, great, great. How are you? And he said, great see you tomorrow. And he walked away and I thought to myself, Why did I say that? I am not great. I, I'm the opposite of great. I don't know what I'm doing. I feel like I'm drowning all the time and like I'm just so sick of pretending everything is okay.

Now I had like no answers how to solve any of these problems. Like I didn't have groceries at home. I didn't have dinner on the table, you know, like I was gonna be charting till 10 or 11 o'clock that night. But I was just tired of pretending it was one more mental load I had to carry all the time. So in that moment I just decided, you know what? Forget it. I'm just gonna, next time somebody asks me how I'm doing, I'm actually just gonna tell them how I'm doing cuz I'm, I'm just so sick of this. So I got on the elevator, took my elevator down to the hallway of shame, and I got off. And lo and behold, there was a friend and colleague of mine Andrea, and God bless her. She asked that dangerous question of, how are you, Erica? And I just kind of unloaded and I said, you know what? I'm not great. We don't have any food at home. I don't know how I'm gonna feed the kids. I'm late to go pick them up. I feel guilty because I'm leaving my patients blah. And I kind of verbally vomited all over her. God bless. And she said two really powerful words to me in that moment. She just said, me too. And honestly, it brought tears to my eyes. I just couldn't believe it. Like there are, there are other people going through this too. I honestly, honestly thought like everyone else had it together but me and in that moment she built a community of two for me, me and her, and that started this incredible kind of bolstering of me and who I was and starting to become my more authentic self and starting to just be honest and vulnerable with what I was going through. 

In addition to that, she then spent the next two minutes walking down that hallway with me and sharing some strategies. Now, this is like, this was like a few years ago, right? So before the pandemic, before all the things she told me about this thing called Amazon where they would like deliver stuff to you. And I was like, what? You know? And then there was like Instacart and they would bring the food to your front door. I mean, this was mind blowing at the time. So I was like, this is fantastic. And that whole drive home, I just kept thinking about not only did she like make me feel less alone, she also just like gave me a strategy, gave me something to go off of, something to build on or some productivity tool. So what I started doing was every time I would go to that hallway, I would look for other people and specifically, sorry, Michael, other women. And I would say like start talking to them. And of course they would ask me how I was doing and I would start to really kind of like, what are you doing for this? Like how do you manage this? How do you manage that? How do you you know, finish your charting so early, you know, all of these things. And they started to share their strategies with me. And along the way we also just started to commiserate. So I would share with them, they would share with me, and we started to build this like sort of informal community in this hallway. So I started to change the name of the hallway to the hallway of strategy, and I actually started to look really forward to going there because I was likely to run in into another woman physician. And I could maybe like pick their brain and they would share something with me that I could use in my life. 

Well, one day I did do this and we had our two minute walk with a colleague, and at the end of it she said, gosh, Erica this is so great. I just wish we had more than this hallway to talk. It's so hard to like, wrap these wonderful conversations up in two minutes. Like, I wish we had a protected time and space where we could really just come together, especially as women physicians and share with each other and kind of step away from our busy clinical and personal lives. That kind of sparked a little light bulb in me and I thought, Hmm, okay, well maybe I can do that. Maybe I could solve that problem. And that was how W P W was born.

Michael: You know, community is something that we all have pretty much through our medical training and then we get dumped into attending hood and we just lose our entire community. So I heard, you know, residency for me was incredibly challenging, but I was surrounded by amazing friends and we all were able to lean on each other and do exactly what you're talking about, which is strategize and talk about the things that were coming up for us and get through our difficult times together. Then you finish your training and you go out into the world and the community just disappears. And it wasn't until I found coaching a couple of years ago that I was able to reestablish a community of doctors and I didn't even know how important that was for me. And so I think it's really amazing that you have kind of, you kind of took this on, right here you are talking about all the things, all the things on your plate, all the things that you felt like you couldn't get done, done in the time that you had allotted to you, and then you took on this task, this enormous task of building a community for women physicians to get together and talk and strategize and commiserate. That's Wow. Tell us, tell us a little bit more about that. Like, so, so you have this idea, how do you go from the idea stage to actually building this community? 

Erica: So my Achilles heel is thinking everything is easier to do than it actually is until I'm in the thick of it. So I literally sat down and I thought, okay, well at that point I was a national speaker. I had spoken a number of times at other institutions and conferences, and I thought, well, I know a number of other speakers that are women physicians. I know who I could reach out to. I've planned a wedding before, so I know how to plan an event. I know how to get C M E because I was teaching a faculty development course at my institution. How hard could this be? Which by the way, it's like so much harder than that. But, you know, ignorance is bliss. And so I just, I started and I thought, well, you know, I remember turning to my husband and I said, you know, I'd been talking and mulling over this idea with him for probably a number of weeks to even months. And I said, am I crazy to do this? Like, I have a full-time job. I have three kids, like I, you know, everything's great. Like, why am I doing this new thing that's adding more to my plate? And he asked me like a really important question. He said, at the end of your life, if you look back and you haven't done this, are you gonna regret it? And I said, yes. And he said, if only 10 people come, will you regret it? I said, no. It just feels like this thing in my soul I have to do. And it's not about how many people attend or how successful it is, it's just this thing that I have to do. And those two questions were really powerful to me and just kind of spurred me on. 

And I just started talking to everyone, which was super uncomfortable. I had never run a business. I was not very entrepreneurial as a child. I had never done any of that. But I just started talking to all the other women physicians that I knew and saying, I'm gonna do this crazy thing. Do you wanna come along? You wanna come hang out with me? And I'll get you CME for it. And we're gonna talk about all the difficult things that nobody ever covers, you know, in medicine, you know, besides the clinical topics. We're gonna talk about that other stuff, you know, so, That's really how it started. And the more I talked about it, it seemed like the more people were excited about it and you, it was one of those you know, jump out of the plane and build the parachute as you fall. So 

Arpita: Yeah. I mean, even going back to your community of two. Like right, that, I don't know. There's something about that. Every single time it gets me choked up a little bit. But you're walking outside and you have the strength to have that vulnerability with this person to explain that, Hey, life kind of sucks ass right now and I can really use a friend and hey, me too. Right? That really hits me because I think that's what holds us back so much from being able to build the communities because we assume that everybody's got their shit together and everybody's okay, and I can't be the one that's not. So I think taking that forward, what you've done is created this safe space, this community where people can be like, you know what? This part of my life sucks right now. Or right now everything sucks and I just need people there to help kind of be my safety net to be loved and supported and maybe give some resources that I might be able to take home with me, or even tips of how I can change things in my life that are doable and easily doable when I go home. And I think that's, that's what's so impactful and so amazing is when I listen to your story about how it started with two and how it's now hundreds of people. 

Erica: I think that's so crucial too. I think so often we do just live in these silos, and you're right, Michael, like I remember having such wonderful support and such a great community of other friends and colleagues around me during residency, and then I graduated. It was like, poof, it's gone. Even though we were all, you know, we were working side by side, but you were all kind of isolated from each other and doing your own work and concentrating on your own patients and over the years, that just became more and more isolating and I felt more and more disconnected from everyone else. And then of course, the thoughts in my head were telling me, everyone else has this figured out. Why can't you figure this out? Now, those were of course, huge assumptions I was making about other people, and it was all about their appearance and not how they were actually doing. And when I opened that door and started to become vulnerable, they took advantage and stepped in and said, I wanna be vulnerable too. Like I was looking for someone to be vulnerable with as well. And this is what W P W is, you know, a place and a time where we can step away from our daily lives to share that vulnerability and to not feel threatened. I really want it to be a safe space and time.

You know, we say this at the beginning of every Women Physician's Wellness conference. You know, this is a safe place. The things that you say here and that you share here do not go home with anyone. Like we keep them here. And I think that's so important just to have that kind of community that you can share some of those challenges with and not feel like you're gonna be judged. And I think so much of you know, what's in our heads is that we are gonna be judged. And I, I think it's surprising when people realize like I can share some of these things, I can say some of this out loud and people will actually embrace me and support me. Like, it's just not what the culture of medicine has created for us. And it's something that we're all trying to work to change.

Michael: For sure, and we're seeing right, all of the impact of not having a community in clinical medicine today, because as we, you know, are struggling to get through the day without community. And feeling more and more siloed and alone. It just, it amplifies the impact of the work, the moral injury, all of the things that we are experiencing throughout the day. That community really does help to mitigate for people. And so I, I know some of the work that you do is helping to keep women physicians in clinical practice. Can you talk a little bit about that?

Erica: Yeah, absolutely. I really, my goal with all of this was, you know, if someone feels like they need to leave medicine, certainly you know, I think everyone's mental health comes first. But beyond that, like I really wanted women to find a community and a support system to lean on each other so they could continue practicing medicine. You know, studies have shown that we are excellent caregivers, we're excellent physicians and so we need to continue to support women so they can stay in medicine. I want women taking care of me when I'm in the nursing home. So how do we continue that and further that and really support those women?

It really, for me, it's funny when I created W P W I, I was burned out and just the act of creating it, and that took, you know, a good year and a half got me out of burnout simply because it was something different. And it was a bit of a creative outlet. It was a learning experience. I loved, I think all of us are lifelong learners as physicians. I really loved learning and trying something new as being an entrepreneur. And trying it in a very creative way, doing things a little bit differently than, you know, kind of the structure of medicine. And in the process of doing that, it actually gave me such a nice outlet that I really got myself out of burnout in addition to the community of women that I was already kind of talking to and you know coming to with my own strategies and challenges. But by the time it was created, I felt great again. I felt like this is what I've needed. I was really creating what I needed for other women as well. And it grew. We started off with 50 women the first year. And then the second year it was at 125. And then of course pandemic, that'll knock anybody on the ground a little bit. And so we switched to virtual for a year. And at that time, in the midst of Covid, I had been approached multiple times by women saying, you've gotta do more than one conference. You know, I, this one backs up to X, Y, or Z, you know whatever other kind of schedule issues I have, so please, you know, create another one. Create one that's stateside. They were asking for all these other conferences and I thought I would love to, but I just, I can't. Like I have three kids. I'm a full-time hospitalist. I'm getting promoted. So it came to a head and I had to decide well, which direction am I gonna go in because I can't do both. And I ended up asking to go part-time and they sadly said no to that request. And that really became a turning point for me. I had to decide which direction I was gonna go in, and I loved medicine, but I also really felt this new passion for W P W and I wanted to see where it went. And I actually felt like, I was touching a lot of lives that were then gonna go and further their patients' lives and continue to stay in medicine longer and create a different culture of medicine. And I felt like, gosh, I might actually be able to affect people in a much bigger way doing W P W and so I left, but not out of burnout or lack of wanting to practice. It was really just not enough hours in the day. 

Arpita: You're honestly, I say this a lot to my fellow coach colleagues and other physicians that are, taking initiatives like this that you are still healing people, you're healing them in a different way, right? Because we have to keep our kind out there and working so that people are there to take care of us and our families. And we want good, smart doctors. And the way we have good, smart doctors is that we enrich their lives with other things other than medicine too. And I will say with the conferences, every time I go, you know, it is a way for me to explore and maybe consider and learn something that I otherwise would not have. And it's just, a nice way to supplement life. Like we forget how to dream, we forget how to do things other than the rat race of life and our job. And so one of the things, one of the beauties of coming together like this is it gives us the opportunity to see what other people are doing, see what other people are offering to help us with, if we wanna do it, and then kind of run with it. And if it works, great. If it doesn't, so what? We can try something else, but it reminds us how to dream again, and that is so important, right? For our own wellness. 

Erica: I completely agree. I know Arpita knows this. And I've talked about this W P W before, but I was diagnosed with breast cancer last year. And my talk even for W P W this year has been about pausing so you can fast forward. And I had a forced pause, you know, I didn't get to, I didn't get to raise my hand and say, yes, I'll take the cancer. And honestly it was a, go figure, it was at a very inconvenient time for me? I, I really needed to not have cancer right then. I, I got diagnosed December before last at the end of 2021, and that meant a mastectomy at the end of January, 2022. Well, I had a conference a month later and I remember people saying like, you need to cancel the conference. And I said, I need this conference now more than they do. Like this community has like been something that I created for them, but now I actually need it. And everyone came out of the woodwork to support me and I needed to show up to just be, feel that energy and be with those people. 

At the same time, nothing like, you know, a diagnosis to really just knock you on your butt and force you to rest. And I'm not actually that good at resting, as I imagine you guys might not be either. We as a physician cohort kind of suck at it but in doing that, it actually allowed me to take moments to reflect. I didn't have anything else I could do. I physically couldn't, you know, go for a run or go for a walk. I just had to sit in a chair and rest and sleep and eat and reflect. And it really allowed me to start to dream in new and even bigger ways for W P W as well as other areas of my life. And that's what my talk this year as Arpita knows has been on, is just how those pauses and those moments of stepping away can allow you to learn something new, learn about something you never learned about before, and then grow from that and decide how you're gonna implement that in your own life and really kind of re-energize you. And maybe fast forward your career or your personal life or another area of your life in a way that you never even imagined.

So, I think so often we look at those moments of dreaming or rest as something that, you know, gosh, like who's got time for that? Like, I gotta get, you know, back to my charting. I gotta go see another patient. I gotta go on rounds. But really taking those moments to pause can do so much for our soul and for our spirit, and allow us to really and the studies have even shown increase our memory retention, increase critical thinking, reflection so many areas of our lives. So I, as you said, there's a lot to those big dreams that it really makes a difference.

Michael: Yeah and community plays such a big role in that as well, just as you were saying, right? Because, because it can be hard for us to rest on our own. Right? But when you're around other people and it is kind of more relaxed and downtime and you can just be experiencing just the 

Arpita: Love. 

Michael: Right, exactly. I'm like kind of looking for the right words, but it gives you some space. It opens up the ability for you to think beyond what your current life looks like. And like you were saying, you know, I had only ever allowed myself to imagine my life just being a doctor, and I am still a full-time practicing physician. And I came to coaching because my life was too busy and too full, and I didn't have time to do all the things that I was already doing and I started a coaching business and have a podcast and spend, you know, a year writing weekly blogs, and all of a sudden I'm doing all of these other things and I'm no longer a burned out physician.

Erica: Isn't that amazing how sometimes doing more will actually get you out of burnout? You know, and everyone needs to kind of find that balance themselves, but I think that's actually so important. And on the flip side, I bet it was those moments of reflection, that allowed you to then say, I think this thing is actually gonna serve me really well and it's gonna help me. I mean, I don't know about you, but I'm just a leadership or professional leadership development junkie. So I remember when, especially as a junior faculty, I was like, don't have this figured out, like somebody teach me. I remember going to a professional development kind of seminar conference for women physicians specifically, and it was 14 hours a day. I just, I, it was 14 straight hours. And I remember getting on the plane after like, three straight days of this, and I was just like, my head is spinning, like there's all these great things that I want to do and apply. And I just feel like my head's gonna explode, and I had not had any time to digest any of it. And then what did I have to do? Go straight back into my practice like the next day. And two years later, I found that folder and I looked through it and I was like, oh, yeah, this would be, these are really good ideas. I should have done some of this. But that's why, so Women Physicians Wellness Conference, we make sure that your afternoons are free. And people may say, oh, like, you know, that's a waste of time, why don't you crunch it into like two days instead of three, et cetera, et cetera. And studies have actually shown that when you take time to reflect on what you just learned, you solidify that knowledge into your long-term memory and you actually are more likely to apply that knowledge long-term.

So I am very strategic and have taken a lot of the knowledge that I've gained from teaching medical education and faculty development over the years, and I've applied it to this conference. So it's actually very thoughtful why you have the afternoons free. If you're well rested, if you are well fed, if your Maslow's hierarchy of needs has been met, you are more likely to have that kind of metacognition and really be able to reflect on your reflections and reflect on your thinking. And so it's all just very strategic and so often we give ourselves a hard time, like, why am I not doing this in a shorter amount of time? Why am I not doing more in this amount of time? But I want you to go take a nap. I want you to spend the afternoon on the beach talking to somebody that you didn't know two days ago and comparing notes and learning something new. Like those are really powerful moments. And I also believe that although we have fantastic speakers like Arpita who's talking to us about processing emotion. Like fantastic, absolutely gold on our stage, there is also gold sitting around you. We have small group discussions with every session, and I want you to get to know your table mates. And we have a assigned seating so that everybody gets to know new people because that new person might be the person that isn't an outside observer that can kinda look at your situation and say, you know what? I don't think you need to think about it this way. I think you need to think about it that way. Or here's something that I bet you've never thought of, or, here's a strategy that's really worked for me. So those are really powerful moments that can happen amongst the people that attend just as much so as the people that are on stage. 

Arpita: And I will say one of my favorite things of your conference is the assigned seating. I mean, it sounds horrific. You're like, what? But you get to meet new people and you get to foster new connections. And it's not even that much about networking. It's like truly creating bonds with other women who are there to do the same thing. And that's one of the most magical things about your conference is that we get to meet people. I mean, inevitably, if we don't have that assigned seating, you're gonna kind of gravitate towards the people that you've already met or know, so, 

Erica: And I tell people all the time, I say like, if you are an extroverted introvert like me, like I can talk to anybody. Like but then I also need my time alone. And I will say like when I walked into those big academic conferences and I would see just a sea of people, it was just sort of like panic inducing for me. So I wanted there to be a way for you to meet new people without having to approach them, you know, have something that was already kind of constructed for you. So this is my way to construct that. So we do, like, we started doing a dinner the night before the conference so you can meet some other attendees. And now we do, and we've done assigned seating. We try to do a lot of things that are kind of, it's an already constructed arena. So when you walk in, you don't have to feel threatened. You can just go, I gotta go to table eight. I'm gonna go sit down and say hi. And that then allows you to meet new people and have a new community that maybe you wouldn't have created before or met before. So that, that just widens those people, those colleagues that can support you in those times of need. 

Arpita: Yeah. Well, Erica, it's been totally a pleasure to learn about the conference and your story for how you've created this. And, and I'm super excited again to be speaking. I'm gracious that you asked me to come back in August in Amelia Island and I guess tell everybody a little bit about how they can find out more about this conference as well as things that are coming up 

Erica: Yes, absolutely. Well, one of the things coming up most shortly is W P W in Amelia Island, which is our W P W Connect conference. So we have three conferences for the Women Physicians Wellness Conference. You can attend any of them. The next one is in August, August 11th, through the 13th. It's in Amelia Islands, so it's stateside, it's Florida. And the benefit of Amelia Island is that we actually take the most highly rated speakers from our other two conferences in Grand Cayman and Aruba, and we invite them to Amelia Island, and that includes Arpita, of course. 

Arpita: I did not know that. That's so kind. I mean, I seriously didn't know that. So that makes me feel good and makes, makes my heart full. 

Erica: It should. It should. You really are fantastic as a speaker, as well as a coach. I mean, all the things, I can't say enough wonderful things about you. So we then have Grand Cayman, which is WPW Climb. Now that one is more focused on career development and leadership development, and then we have WPW Clarity in Aruba, which is more focused on personal development, resilience, and burnout. And so the benefit of WPW Connect in Amelia Island is that because we have the top rated speakers from the other two that come to Amelia Island, you get a taste of both of the other two conferences as well. So there's a lot of benefit. And I mean, I don't think that there's a conference that you can go wrong with. People ask me, which is my favorite. I mean, it's like, picking your favorite child. Like I, I love them all equally and in different ways. 

And if you wanna learn any more about the conference you can just go to the website, women physicians wellness.com. Physicians with an s, multiple plural. or you can just email me [email protected]. We have a Facebook group Women Physicians Wellness Conference and then our Instagram handle is W PW Conference.

Arpita: That's awesome and we'll put all of that in the show notes for our listeners so they can listen in. and again, such a pleasure having you, Erica. I'm excited to see you in a couple of months and thank you again. I look forward to speaking to you more and hugging you in person again and seeing you again. 

Erica: I love it. Thank you both so much, Michael, Arpita. I so appreciate the opportunity and it's so nice to be able to talk to your audience.

Michael: Well, thank you again so much for being here and thanks everybody for listening and we will see you next time on Doctor's Living Deliberately. Take care. 

Arpita: Bye. 

Michael: Bye.